The use of the Personal Digital Assistant (PDA) among personnel and students in health care: a review.
BACKGROUND
Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications.


OBJECTIVE
The aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care.


METHODS
The literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen's Model of System Acceptability as a theoretical framework in structuring and presenting the results.


RESULTS
From the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen's Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning.


CONCLUSIONS
This overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.
Lindquist
Anna M
AM
E-Health Institute, University of Kalmar, Kalmar, Sweden.
Johansson
Pauline E
PE
Petersson
Göran I
GI
Saveman
Britt-Inger
BI
Nilsson
Gunilla C
GC
D034201:Computers, Handheld / Q000592:standards; D003695:Delivery of Health Care / Q000592:standards*; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D007802:Language; D007857:Leadership; D007858:Learning; D008490:Medical Informatics / Q000592:standards*; D008492:Medical Informatics Computing / Q000592:standards*; D010380:Peer Review; D010506:Periodicals as Topic / Q000592:standards; D011369:Professional-Patient Relations; D011643:Publishing / Q000592:standards; D013334:Students; D013663:Teaching / Q000592:standards*